Nurses Needed

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The Weekly Q

By the year 2020, a nationwide shortage of up to 500,000 trained nurses could mean that hundreds of thousands of patients will receive less attention and substandard treatment. Just as alarming, fewer nurses are choosing to teach the next generation of professionals, resulting in tens of thousands of applicants being turned away from the nation's nursing schools.

This week, NOW on PBS takes a hard look at the strains this crisis is placing on the entire medical system, as well as innovative efforts to reverse the trend.

"If there was ever a time in the history of this country when one thought about the match between a profession and the changing needs of people in the country, this is the time," Dr. Mary Naylor of the University of Pennsylvania School of Nursing tells NOW on PBS.

A Week in the Life: Nurse Joannie
A new nurse writes about the trials and triumphs she faced during her orientation.

Patient Update: Nicole Marquez
Find out the latest on Nicole, who was featured in our show.

This show was originally broadcast on October 24, 2008.

Related Links:

Jonas Center for Nursing Excellence, aims to advance the quality of patient-centered health care through nurse recruitment and retention, and responsive practice models. (The Jonas Center for Nursing Excellence is a partial funder of "Nurses Needed").

Video: Interview: Nursing from Hospital to HomeDavid talks with Dr. Mary Naylor about a new approach to dealing with the complex needs of chronically ill patients that could also reduce health care costs.

Commenter:JoshI am a male nurse with a Bachelors Degree in nursing. I've applied to more than 250 jobs, in anything from hospitals to nursing homes. Result? 100% rejection rate.

Nobody is willing to hire new grad-nurses unless you've got special connections with somebody. THERE IS NO NURSING SHORTAGE, otherwise they would hire new nurses like me. Everybody says "the shortage has eased in certain regions" but nobody can say which region has jobs. Look, if you want a job you better be careful cuz I've been searching for ANY TYPE OF RN JOB... i don't care where, i'll take anything but after 7 months of searching i still have gotten only an inbox full of rejection emails.

Commenter:sijee maria josephUSA NEEDS many nurses to serve the citizen of US, so president obama must change his view of not allowing foreign nurses to USA.So he should give more opportunity to foreign nurses to come and serve USA.

Commenter:Kate HathawayIf there is such a nursing shortage then why can't we find jobs? As a new graduate I have applied for every job opening and have not recieved a single call. My fiance who has 5 years critical care nursing experience is also unemployed, he also has applied to every opening, is willing to take a salary cut, yet has been unemployed since Novemeber

Commenter:BrentThey should do a story on how people like my wife are currently graduate nurses getting no calls. All the hospitals want 1 to 2 years of time in a hospital but none want to do an internship like the one in this story. My wife graduated 2nd in her nursing class of 146 nurses with a 3.88 GPA, President's List, Highest Honors and has ACLS and BLS and passed her RN exam with flying colors and not one call of interest. Plus she was a medical assistant so she is used to touching patients. Yet because she does not have at least 1 year of experience yet not one call. People are changing their majors from nursing due to a lack of nurses. So when they cry about not having enough nursing I have to laugh because there are hundreds here in Jacksonville that are waiting for jobs. Many would work for free to get their initial training yet nothing from local hospitals. Just wait until all these baby boomer retire and the nursing shortage will be even worse than we thought before the recession!!!!

Commenter:connieconnecticut is looking to discontinue the state sponcered LPN program to save money....what idiots!

Commenter:CaseyOne of the reason there are not enough nurses is because most of the diploma schools have closed. BSN programs train nurses to be managers but if there are no nurses to manage what then?

Commenter:Lorraine RNNursing shortage, baloney! Since moving to the mid-west, I have been rejected by several hospitals because they tell me there is a hiring freeze.

While the physicians drive to and from the hospitals in their expensive cars, and the hospitals administrators take exotic vacations, the nurses are told there is a hiring freeze so the patients don't get adequate care

I now teach Certified Nursing Assistants a course called TMA (Trained Medication Aide) through a community college. There is a great need for TMA's because the health care facilities will pay the lower salaries to them rather than pay the higher cost of a Registered Nurse or LPN.

Health care facilities need to get their priorities straight

Commenter:R.F. RNThere is no nursing shortage.I've been out of school for six months already and I haven't gotten a hospital job yet. Though everyone aggrees that most hospitals are understaffed with nurses, this makes no differnce since the hospitals are refusing to higher more nurses. This is becouse it would be more costly for them.Due to the fact that I am a new graduate I would have to go through an extensive orientation which would cost them more money then an experienced nurse .Therefore I would not encourage others right now to go to nursing school becouse no hospital is going to even give them a chance to get started.

Commenter:Diana RNI must also ask "what nursing shortage"? I have been in nursing for 30yrs. and I have never seen such deplorable working conditions. Hospitals have cut nursing staff down to the bare bone. It's like running a marathon, no breaks, a few minutes to eat and you're off giving meds and doing endless paperwork! Patients aren't getting the care they deserve or the teaching they need because the number of patients nurses are responsible for keeps increasing and the patients are sicker. It's a no brainer really, with scientific research to support it,safe nursing staff to patient ratios need to be established NOW. It would 1.cut down on time spent in hospitals 2.time for Patient teaching cuts down on readmits 3.error rates go down 4. infections go down as do complications in general, to name a few benefits. There isn't a nursing shortage in the Northeast because hospitals have made such deep cuts in nursing staff and now have'techs' doing more all the time, they are not liscensed and usually get trained after being hired by the hospital. I witnessed first hand how serious the situation is when a family member became seriously ill, when I had to leave for brief periods I told him - question everything, every med, every test,and know the title of whoever enters your room and why they are there. This was a large reputable teaching hospital and it was a very scary place. I feel every pt. needs an advocate at their side, a role nurses used to fill, but with ever increasing workloads they're running on empty and told do everything faster and ..... faster still. I love nursing but I can't do it this way. Searching for another way !

Commenter:Sari BronerAnother wonderful NOW program! (Doing without TV, I watch online, by the way.) My recent experience in New York caring for my father and mother is where I learned the importance of nursing and of organizations that use nurses in an important way. My father went into home hospice and my mother is not well enough to meet many of his needs -- he has Parkinson's Disease. The hospice is headed by a nurse who is very much in contact with my father's doctors. We were also sent a social worker, a nutritionist, physical therapist, a podiatrist, and a chaplin. Medications were refilled and delivered to us with a phone call. Each person has helped us enormously. All were coordinated by our very dear nurse; a 24-hour hotline to VNSY Hospice is answered by nurses who explain how to handle a situation or refer us on. So, an experience that by its nature is painful, became one that put an emphasis on life, on care. It isn't that the doctors weren't important and wonderful; they are. But, they are used in their capacity of medical expertise. We are more than wounds and our illnesses. My father's trips to the hospital have gone way down. He is stronger and happier than he was before the hospice team stepped in. How I wish all our medical case resembled this model!

Commenter:Lucy StricklinI am a CNA I DO work withthe county, personal care, home health,hospice...igot into this worh after 40 years as a office manager,bookkeeper..wish i could have gotten in sooner..thi programis wonderful..Some of my patients are ones with spina bifda, 100 years old lady, 95 and 86 years old people..Keep up the great work

Commenter:Karenpowerful and accurate. Unfortunately for our patients and ourselves, we are seen as an expense to many hospitals and other medical arenas. My question is ...What shortage?! You would never know it based on hiring/firing practices in many areas of the US.
One system I've worked with has actually laid nurses off to "right size." Much of what we do is unseen to either the patient or family, we are not good about communicating what we do to the public so much is hidden.
Cyclical shortages have occurred in the 20 some yrs of my practice and bandages but not real solutions have been applied. It's a multi-factorial problem that has no easy answers, I feel that our own organization (ANA) hasn't helped the problem by promoting a better understanding of a nurse's role or placing us in the public view. when the AMA takes a position, news people follow it and listen. When the ANA does also, nothing is noted, i.e what is our stance on health care reform, does the public know?

Commenter:RN: Undisclosed for fear of retaliation.One of the vital areas missed on the nursing shortage is the manner in which many nurses treat one another. Have you heard the phrase, "Nurses eat their young." For the state of Arizona, that seems to be their motto..starting with the AZ Board of Nursing. You are guilty unless you prove yourself innocent.

I agree that while the salary is a significant factor, there is a strong intrinsic reward that nurses receive from our profession. It often isn't any reinforcement you receive from the administrators because they are there to remind you of your faults and weaknesses instead of the postive reinforcemnt that is always nice to receive.

ALL nurses aren't out for blood. It's just those who are try to make life miserable for the rest of us.

Commenter:tom shermanI see no mention of Nurse Anesthetists in your programing. Best kept secret in health care.

Commenter:Deon Watson, RNFantastic videos and articles. If I wasn't already a nurse, I would want to become a nurse.

Commenter:D. Aaron French, RNPBS performed a fine job in revealing the problems in health care. Without Nurses, hospitals are inoperatable. Our country needs to work with Nurses to identify and correct the Nursing Shortage, NY Presby Hospital is doing an outstanding job at retention and recruitment, the country can learn from this model Yes, we need more educators and more bedside Nurses, but the pay and benefits must match the demand and the working conditions must provide a safe place for patients and a safe work environment for the Nurse. Nurses hold liability for their practice, the days of bed maiden Nurses are gone, Nurses must be critical thinkers, they must view the whole patient picture and act appropriately, this is a fundamental requirement for Nurses today. The recognition and needed support from hospitals and the government are key requirements to reduce the shortage of Nurses and to progress the profession, so that Nurses return to the beside, and are motivated to educate new Nurses. We can solve this shortage, but the country needs to invest money into this, they must believe in this, otherwise, health care reform will be meaningless without the Nurses needed to care for our patients.

Commenter:someone who has worked with Foreign RNsRonald, have you worked with these Rns from the philippines of india, I bet not. I am guessing it is your business to get them over here. Well I have and they take even more training to get most of them ready. I will admit the RNs from the Philippines are better than the ones from India but, most of them have not been taugh Critical thinking and they tend to just follow orders.
That is one reason nursing is so difficult, Nurses need to know how to do the job, care for the patients, be sensitive to all of their needs and make sure the doctors orders are done and monitor the outcome. These nurses from other countries do the orders but do not monitor for the outcomes. Not to mention as someone else commented, they come in and get paid less and so hospitals are not made in increase our nurses pay rates.
Another comment that I read was how we dont see pay increases and certainly not cost of living increases. How many nurses do you know that have had benefits slashed, our 401 k is our only retirement and the hospitals have constantly cut back on how much they contribute. They have taken away shift differentials, weekend differentials and in the south now we dont even get holidays off with pay, we have to take our own PTO to get paid for Thanksgivein and Christmas. That hasnt happened in most places up north but it has here in the south, where they are using more foreign nurses.
Also let me tell you the hospitals that use these foreigh nurses get burned in another way. They bring them here and spend alot of time and energy getting them up to our level of nursing and then they put in their time they owe the hospital and then they move on and the hosptial is left short again.
NO FOREIGN NURSES NEEDED. TAKE CARE OF THE ONES YOU HAVE AND THEY WILL STAY.

Commenter:Margie BI just watched your show on nurses in the web, I found it through AOL. I just wanted to thank you for showing nursing in its true sense. I watch Mercy on TV and although she does heroic things, the way she works is not real and I dont beleive it shows nursing in the best light. I also watch Three Rivers and although I like the show, the nurses are really left out, the doctors do the things real nurses do, the thing that bothers me about that is that I used to work in the CTICU with transplants for 20 years in Pittsburgh, and that unit has some of the greatest nurses and we gave exceptional care. Nursing is hard work but it is more rewarding than just about any other job. What Willie said about what keeps nurses working is true, unfortunately, most places dont provide it and we are not paid as well as we should be, we are the ones keeping people alive. We work because we are generally helping caring people. Good nurses are harder and harder to find and we older ones are burning out, it is very physically demanding.
Thank You Again for doing such a true show,
Margie Bowman-Srnik

Commenter:VinnieI haven't had the opportunity to view the show. I can however, say that although a nursing shortage does exist the odds are not in your favor for finding work. If your not aware there is a downsizing of hospitals here in the NY area where I reside. This has resulted in fewer available nursing positions and layoffs. Compounded with our current economic problems has translated to a hiring freeze. So if your a new nursing graduate tring to find employment current opportunities will difficult to find. I call this double sword economics at work. We need nurses but economics right now has proven otherwise.

Commenter:ALFREDA MCINTOSHWHY NOT ENCOURAGE OLDER NURSES THAT MAY NOT BE PHYSICALLY ABLE TO DO BEDSIDE NURSING TO FURTHER THEIR EDUCATION AND TEACH. THE BENEFITS ARE BOTH KNOWLEDGE AND EXPERIENCE.

Commenter:Rubin Thomaswe can recruit nurses from India,they are hard working in this field

Commenter:ShawnaThis is nonsense. If there is a shortage, I don't know where it is! Hospitals and many LTC places are not hiring new grads. There are people searching over a year for jobs and it seems to be a crisis for new grads. What should a new grad do when the media project "Shortage" and you get out of school and there are no jobs and the expensive student loans and bills incurred are left unpaid resulting in bad credit. Bad credit creates another problem when someone will finally hires you and do a background check. Go to allnurses.com forum (it's a blog) see how many new nurses are not being hired and crying out for jobs and to get your foot in the door. I went to a job fair the other day in NYC, I saw 100s possible over a 1000 young men and women standing in the new grad line just to introduce themselves to nurse recruiters....I said to myself, "NYC will never have enough openings in years to come for all these applicants." This is not to mention the upcoming graduating classes of Dec 2009 and May 2010....they have to be met with all of the other stale graduate fighting for an interview. I am not saying that maybe in some states they are no shortages but the media keep projecting the national shortage and to the eyes of a frustrated new grad, its just a media hype!

Commenter:L.KIt is a great program. Thank you.

Commenter:Georgina KThank you for this program. It shows a true picture of what nurses are going through. Can you imagine this busy nurse having a student on top of everything? Hospitals in my city are populated with huge amount of students because we have lots of students. In those hospitals every nurse on a day shift knows that she might end up with a student. I am a nursing student and if nurse is busy, we do not learn a lot because nurse is the one who we learn from the most about nursing. Our teachers play a big role too in our learning but nurses are those from who we learn about real job. Working with us students is hard and most nurses do not see themselves responsible for teaching us and if fact they are not, but they should be. This is something hospitals and schools should work together on so that nurses could be more motivated to teach students and in return schools will produce better students and hospitals will get better prepared new grads nurses.

My opinion is that the dropout rate from nursing schools is mostly do to the fact of the nursing program itself. I am a nursing student and it is almost impossible for student to get through this program if you are not an "A" student. I think that there are many people who are not bright academically would of made a great nurses because of their ability to work with people. But, it impossible to get into the program if you have less than GPA of less than 3.5. It is hard to get into nursing program and it is even harder to make through it.

We can also blame NCLEX testing that forced our schools to focus more on theory in order to prepare us for the NCLEX. We have lot of theory classes and not enough clinical experience. I think the program itself should reflect more what are we going to deal with on the job. Even though we get some clinical experience it is not a good quality because nurses are busy. We are on our own to learn and it is tough. The hospitals should work together with schools to produce better nurses. It is hard for nurses to work with the students and get everything done and only a few nurses would work extra hard to help students learn. Nurses who have a student should have less patients or get other rewards for their hard work.

I think that nursing schools and hospitals should make some changes to make it easier to get through the program and still get good quality experience. I am almost done with my school, I am a "A" student, I studied hard for 2 years of nursing school and did not have "a life" for those 2 years but I still do not feel like I am well prepared to enter the nursing profession. This might be the reason why new grads cannot get a job because hospitals need to spend a lot of time and money to train us and prepare us to enter nursing field.

Commenter:Kathleen SpencerNursing is back breaking labor. Management and some patients and patients' families treat you like dirt. Very many nurses are non-unionized and don't even have health insurance of their own. I've been a nurse for 24 yrs. I quit!

Commenter:AbbyThe solution is simple if people want more nurses they need to pay as much to the nurse educators as they would be making in the hospitals!

Commenter:PaulGood info. For those commenting below about hospitals accepting "new grads" ... you need to go to a respectable university, not a college for "boneheads" ... this was also addressed in the program...if you're stupid, you won't get hired! Derrrr

Commenter:Marion Lavery BSNEd.,RNI started out as a U.S.Cadet Nurse during WWII. You have captured the important fact that nurses are the "cement" that holds the hospitals together. Johnson

Commenter:Marianne LindseyThough your program was only 30 mins long, "Nurses Needed" covered many key issues. Having been an intensive care registered nurse for 32 1/2 yr. I can truly identify with the concerns that so many nurses expressed. The bottom line is this, "If more was done for retention of experienced nurses, recruitment wouldn't be a problem."

The stress of the working environment dealing with people's lives is tremendous. It is compounded by adding shift work, especially 12 hr shifts. Take just that one issue and track the nursing burnout because of sleep deprivation and exhaustion. Look back before 12 hr. shifts were instituted and examine the attrition rate. This is but one critical issue.

The mentorship of new graduates nurses was well reported. This is a another key concern, affecting quality patient care delivery, decrease medication errors, increased job satisfacation, and effective use of resources to decrease the financial cost of the institution over time.

Providing opportunities for staff nurses to govern themselves and affect the outcome of their work environments is paramount. Refer to the "Healthy Work Environment" initiative by the American Association of Critical-Care Nurses (aacn.org).

I truly appreciate your excellent reporting of this issue.

Commenter:Tonya HarbisonGreat news report!!! I'm sharing this with my Lpn students at Mississippi Gulf Coast Junior College. We need more nurses committed to providing the best care for our nation. I want to find a copy of the DVD to share with my students. Very rewarding

Commenter:Carol Yeager RNMy daughter and I watched your program, and the timing could not have been more perfect. One night previously, we watched "Mercy", a new series about nurses. The portrait of a nurse in that program, featured immaturity, abetting a felon, stealing drugs, and of course doctor chasing. The NOW program was so real and honest. This the nurse that I worked with and admired-- loving, caring, and treating their patients as if they were family. As the mother of the injured dancer stated-- the nurses BECAME their new family. God bless all of the people who helped with this program. I felt happy and proud to have known and worked with all of my fellow nurses.

Commenter:Janet DMaybe they should hire the new grad nurses, so there wouldn't be such a shortage. Do you know how many nurses that graduated in May 2009, that are still unemployed? Hire nurses schooled here before you go looking overseas.

Commenter:james nailoryour views are so close to mine i thought you had stolen my identity

Commenter:Sara RNI've heard this shortage for years but there are tons of new grads out there. This is the problem. When are hospitals going to accept new grads???

Commenter:TrinaD. Otamere, LPNThank you for this story! However, please remember that the nursing shortage is not just within the hospital. I have been a nurse for 14 years now and have worked in several areas within the nursing profession. I have been a: Med/surg, NICU, Women's services, Home Health, Hospice, Private duty, Develomental Disabilties, Utalization Management and Amblatory Care Nurse. I have worked in Military, Civilian Hospitals as well with Nursing Agencies, Insurance companies, Doctor's Offices, Individual patient homes, Group Homes and Nursing Homes. There has always been a shortage and it is not getting any better.
I have read every post here and everyone has a good point!
So my question now is what is our next step?

Commenter:Claire D. RNI loved the program but was disappointed again that you did not talk to more nurses outside of hospitals and those not chosen by nursing administration to interview.
Nursing is partially to blame for the current crisis by not keeping the diploma programs alive and merging them with the BSN programs.Instead the profession decided to pursue the Montag module. We have in essence now produced two types of nurses; Associates and BSN. The two year grads are supposed to be the quick fix for a workforce shortage. BSN'S were supposed to manage the system according to this rhetorical theorem. The next fix was to increase the scope of practice for technicians, and to confuse and endanger the public further with not standardizing the educational processes and titles for anyone whose professional standing is less than that of an RN. Turn 'em out faster but don't equip them with enough real education. The extra clinical time now deducted from the educational process of preparation for nurses has contributed to the drop out rates in the first year of transitioning nurses into the work environment. They did studies on this years ago. Why,because now, there are more very developed technical areas and knowledge that all nurses have to have to function in the work environment, And, an increase in the aged population, and they are much sicker.
We were trained to deliver and practice preventative medicine and nursing care but that is not what we practice. We practice in a crisis mode. I say this because I lived through this. I graduated on a friday and went to work the following monday in an early undifferentiated ICU UNIT 27 years ago with no orientation. I am a third generation nurse in my family.
Now, as your program reports, some hospitals are providing internships of a year for the education these folks did not get at nursing school. The rest of nurses whose workplace does not offer internships, orientation, training or support hang on with whatever they have. This is another factor in the dropout rate.
I am an older nurse who has been assaulted on the job, gotten sick by some exposure to something on the job, had surgery because of the job and lack the stamina I once had. Yeah, I am getting older.My workplace and culture often discriminate and devalue older women like me. Hospitals don't like older experienced RN'S because they have to pay more money. I believe, we have earned it and yes money is a FACTOR. So are all of the other factors the other RN's have reported to you.
The Democrats and Republicans BOTH have chosen to ignore us and have not done anything to supply us with any relief for our workplace problems,educational or financial help other than to continue slave contracts to hospitals or state programs in exchange for education. There has to be more available for us. We are the BACKBONE of the Healthcare system. There is no need to import nurses. We need to FIX our own problems. That will require more shows like this and more nurses to speak out about this in public venues.The nursing shortage has always been there, and will probably always be, because you cannot make people who care.It has been growing for years and has been publicly ignored or deemed unnewsworthy as I was told after a complaint lodged with the local tv station for misreporting wages and other things already mentioned here. It's always the same rhetoric.
The public has little concept of what we really do,how we do it and the ca-ca we are expected to accept. My nursing school motto was the best way of putting it, " The dumb come, The stupid stay but only the strong survive." Thank You for remembering us.

Commenter:Amanda RNWOW! Thank you SO MUCH for this story. You did an EXCELLENT job showing the realities of nursing! I hope more people will understand that it's the NURSES care for the patients 24 hours a day after the doctor has spent about 15 minutes making rounds. Nurses are the eyes, ears, and hands that monitor the patients and give doctors critical information needed for care decisions! THANK YOU!

Commenter:Peggy Felipe RNI am retired after 30 years in a medium city hospital
15 years in critical care. I have not retired from nursing and now work in a hospice home.
I loved the program and know the hard work involved in critical care. Good job.

Commenter:Robert FrantzIt's critical that colleges and universities receive state and federal funds to support nursing education. Hospitals and state nursing boards need to collbarate directly with schools regarding the nursing educational programs and promote and mentor these programs.

Commenter:Ann MellemaI watched the last half of your show, it was wonderful to hear how enthusiastic these nurses are !! I have been an ICU nurse for the last 25 years and currently practicing in Florida. I love my job and feel extremely blessed to be able to do what I do.
Thanks for getting the word out !!
The ending brought tears to my eyes. So many times we never see a pt leave the hospital or return to say hello, thanks for showing that too.

Commenter:Debbie C. Paul BSN MBAWow! This program hit the nail on the head. I was a critical care nurse for 17 years and also managed intensive care units and David Brancaccio and his staff communicated the essence of nursing and the nursing shortage issues magnificently clear. A brilliant piece of work. Well done! Now - what can we do collectively about improving the massive nursing shortage that is about to strike any of us that consume health care services?

Commenter:jameExcellent show...My son has just decided to go into nursing. I'm very proud of him and hope that he finds joy and satisfaction in helping those in need.

Commenter:Jean R.N. .Your program was excellent and I think the hospital shown is a role model for trying to address the nursing shortage. I hope it works for them. I have been a nurse for 30 plus years. My health and my back have held up but my emotional strength to do my job is waning. I returned to hospital nursing 2 years ago after 20 years in an outpatient surgery center. I anticipated liking hospital work again but it has been anything but rewarding. I got a 3 week orientation, a "crash course" at best I'd call it, then was expected to be a full team member. This included computer charting which I had never done and working with equipment I had never seen. We work everyday with minimal staffing. Many days I work 10-12 hours with one 30 minute lunch break! Our small community hospital is struggling in the current economy so raises and 401 matches are non-existent now. I barely clear $50,000 per year and it's just not worth it. When the job market improves I will be leaving hospital nursing and probably will never go back to it. Sadly, I would never encourage anyone to go into hospital nursing profession these days.

Commenter:brendai am a licensed pracital nurse. I have been an lpn for 24 years and love it always have. I have been unable to financially go back to school due to family responsibility. If I did go back now I could possibly loose my house, autos and health care--all much needed now a days. I feel I do well as a nurse but the lpns are being eliminated by the Registered Nurses. I have also worked with some VERY poor RNs but they are not being eliminated. The nursing shortage is going to get worse when the lpns are gone, unable to be an RN What to do--keep the lpns or grandfather us in after testing us, something needs to be available to us as working lpns.

Commenter:Susan RheaWhat is diverse about the five female voices from Colorado. They all express the same thing - Hillary supporters who have trouble going with Obama. There is plenty of diversity among women in Colorado- plenty of women who gladly left Hillary when she went feral last spring, plenty who supported Obama from the beginning, plenty who still enthusiastically support McCain. I am in the first group - Hillary went nuts, Obama stayed cool, calm, and collected, and I believe will the best president the world has ever seen.

Commenter:Jim K, RNI commend PBS for this episode. It is so rare that I see anything about nurses/nursing in the media. While nurses are one of the most trusted groups of professionals as polls show, we evidently are not worthy or interesting enough for much representation in the media or on all the medical T.V. shows...
I will have to agree that until compensation for clinical nurses and nursing faculty reaches certain levels, you will not see the needed numbers come to the profession. However, as several comments above illustrate--there are also many other factors about nursing that make many nurses throw in the towel besides just money...

Commenter:Sandy Blakei am one of the hundreds of thousands of licensed nurses who refuse to be brutalized by the hospital system. there is no shortage of nurses. we don't want to take nurses away from their own countries where they're needed even more. we just want a decent deal. if you want to show the truth about what it's really like in the trenches, talk to us.

Commenter:Sylvia BoeckerYou missed the point entirely. There are today, thousands of fully licensed (in the state of intended employment) English speaking nurses who are ready to come to the U.S.A. to work in health care facilities. Their petitions are approved, they have taken all the exams, and have the equivalent of a U.S. Bachelor of Science in Nursing degree. There is no reason for such a shortage when qualified, licensed nurses are ready to come here to work. Congress is clearly responsible for the shortage of RNs in the U.S.A. Speak to Congress and hold them accountable.
Every patient who complains about lack of nurses should blame Congress. The Philippines produces nurses for export, there are far too many nurses in the Philippines. They depend on coming abroad to work. Issue thousands of unused immigrant visas to nurses and the shortage will be alleviated.

Commenter:Karen FlemingYou program on the nursing shortage was exellent in that it made the public aware of the critical issue that faces our nation's provision of safe healthcare. However, you did not mention the fact that there is a bill in the House Judiciary Committee (HR 5924) that will help our situation. It contains a prvision for visas for foreign educated nurses and physical therapists; a $1500 fee for each nurse visa that is paid by the employer and goes into a fund to increase instructors salaries, improve equipment in the classroom and provide scholarships for nursing students; and a pilot program for career ladders in hosptials sith support from educational institutions so that a CNA can become an RN, RN to BSN to Masters to instructor.

This bill provides the time we need to grow our own through bringing in foreign educated nurses to insure patient safety while the other 2 components help us produce more US nurses.

Commenter:katieI am shocked and very disappointed that you research did not include the licensed practical nurses, and cerified nursing assistants also they are the backbone of the long term care and home healthcare industry which as going to increase in the next 10 to 15 years as out population grows older LPNS are nurses.Just wiat till we all retire or get oout of this profession , why because low wages,lack of respect and acknowledgement,I feel whe they took the LPn out of the hospital setting they did a GRAVE injustice to the profession, We work sometimes 16 hour shifts with up to 40 patients to administer medications,IVS. procedures skin and wound care, going with the doctors when they assess at least 10 to 15 patients,transcibing drs orders,and multiple interuptions with demanding elderly and there families, loveingly of course, meeting the physical,pyschologial and sometimes the spiritual needs of up to 30 to 40 patients ,this isfor one lpn only so dont forget us in the mic and also the nurse aids who break ther backs transferring patients to and from bed because ther is never enough patient lifts, Sore feet and sore backs My God who is going to take care of us? The government hmm we shall see . Tiredly your A very Tired nurse.

Commenter:RobertI really enjoyed this show but it overlooked a huge problem in nursing; nurses are often treated horribly by hospitals.

Commenter:H. M., RNYou really get it!
I was very impressed by the accuracy and thoroughness of your depiction of the current and future nurse shortage in Nurses Needed. The public in general doesn't have the first clue about what nurses really do from the sheer percentage of patient care that we provide vs.the doctor, to the minute by minute life-or-death decisions nurses make all day every day. Plus in the real world, especially on the off-shifts, you may have an admission arriving in pain from the ER who needs assessing and has about 20 min of paperwork to complete, a fall-prone patient trying to jump out of bed despite a bed alarm and call light within reach, an irate family member who wants to tell you everything that is wrong with the hospital-and all at the time you are trying to give the four cardiac patients you ALREADY have their medication accurately and in a timely manner. Administration's answer to this; fewer people and more documentation. No, I do not resent emptying bedpans/ trashcans, finding supplies, running down to the room to make sure Mom has her phone-but nowhere is the recognition that these things might not take priority over,say, doing a medication pass without distraction or assessing someone who suddenly becomes short of breath. Not only are we required to be all things to all people all the time, but according to a recent study, we are now spending about one third of our time doing paperwork, much of which is redundant, and ALL of which comes directly out of the limited time we do have to care for an increased number of patients.
Speaking from experience, the way a hospital can boost nurse retention is to keep the fancy logo lunch-bags and tote bags and foster an environment in which nurses can safely concetrate on providing nursing care.

Commenter:Mary Susan GrecoI commend you on your Oct. 24th broadcast depicting the imminent nursing shortage, however, one 30 minute documentary only touches the tip of the iceburg of this healthcare crisis situation.

Hospitals across the country are already experiencing difficulties related to nursing shortages, a problem that is only going to get worse. I would like to see a series of NOW episodes dedicated to further exploring root causes and possible solutions to this problem.

While your broadcast highlighted the tremendous skill and compassion of the nurses portrayed, the real problems facing nurses were only briefly and incompletely depicted, no doubt due to the time constraints of the program.

The variety of issues influencing the nursing shortage need to be fully explored and understood to be solved. The need for more nurse educators, the factors that influence early professional burnout and the oftentimes misleading public perception of the profession are just a few factors that are contibuting to this shortage. While your online abstract of this documentary mentioned some of these contributing factors, the program itself addressed these issues only very briefly.

The vital role of the nurse in healthcare also needs to be defined in more detail to fully inform the public of the importance of nurses to the overall healthcare delivery system.

It is only with increased public understanding and awareness of this impending nursing shortage and how this shortage will negatively affect healthcare quality and accessibility for everyone that this situation will get the public recognition it deserves.

The PBS NOW broadcast is highly respected and widely viewed. The efforts of your network to further highlight this problem will help galvanize the public to join forces with nursing professionals, creating a groundswell of demand for a solution to this crisis.

Thank you for taking an interest in this issue. Your further attention to this problem would be greatly appreciated.

Sincerely,
Mary Susan Greco, RN

Commenter:Ronald NairThis commenting on Nurses Needed show. While I applaud NOW for addressing this problem, it did NOT go into all of the practical options such as augmenting the US Nursing workforce with foreign nurses via Nursing Immigration. US High Technology industry augmented its work force through immigration, and foreign nurses recruited from India and the Philippines currently represent the best short term solution within the next 1-4 years to 1) to alleviate the RN shortage in the hospitals, sub-acute centers ,and Nursing homes, AND 2) providing vital funding to Nursing Schools across the nation to hire new faculty to train more American Nurses.

INDEED, there was an immigration bill that died in the past term of the US Congress that would have 1) allow for the immigration of Foreign Nurses up to 20,000 per year for three years, and 2) provided over $90 Million Dollars for funding to America's Nursing Schools to hire new faculty and pay for American Students, and this would have been paid for by the private sector through a special $1500 Immigration Tax for each immigration visa given to a foreign nurse. There are currently thousands of Immigration Qualified and license eligible foreign nurses in India and the Philippines [who passed NCLEX & required English Speaking examinations] waiting to come to the USA. However, currently its taking about 4 and 8 years for a Nurses to Immigrate to the USA from the Philippines and India respectively due to Immigration restrictions.

One practical, economic, and REALISTIC way of solving Nursing Shortage problem is reforming our immigration law to allow the immigration of, like other countries, targeted shortage occupations like Nursing. No immigration reform will only worsen shortage and result in these qualified Foreign Nurses going to other countries.

Commenter:Roberta Rana, RN, MSNThank you NOW for an informative and always passionate program. The technology and expertise of nursing care in the hospital setting was important for those viewers who never understood the intense complexity involved in nursing practice. However, this same expertise is found in the school nurses' office, the industrial sites, and the community settings. The nurse is often working alone, an independent agent on the front line, responsible for critical decisions that affect lives on a daily basis. Nursing has evolved from generations of people who were motivated by mission rather than economics. Retaining young people to stay in a field that requires an intense scientific education, long hours and an often physically and emotionally challenging environment, most likely accounts for the deficit in numbers.Hopefully those truly interested in nursing as a carrer got a jumpstart from NOW.

Thank you.

Commenter:Kathleen BoyerOf particular interest in this story was the explanation for the lack of qualified nursing instructors because teaching pays so much less than hospital nursing. While both true and important, the assumption is that qualified nurses are all still working. There is a plethora of non-working or prematurely retired masters-prepared nurses like myself all over the country.

The physical demands and long hours have become just too much for many of us in our fifties and early sixties. Nursing leaders have totally overlooked us as an important resource for nursing education in most parts of the country. Nursing has its political problems just like any other occupation and has consequently overlooked and underutilized an excellent source for recruiting nursing educators.

Commenter:Pollie SamsonMuch of what you showed on this program was about critical care units. I have worked the Emergency Room, ICU, and Acute Dialysis. But I think it is just as important to tell the public that nurses on the routine hospital floors is even more difficult than the work done in the units. We always talk about critical care, but it is the nurses on the floors that keep patients from winding up in the ICUs bu interviening in the patients' care before they become so ill that they need ICU care. The floor nurses do this while taking care of far more patients and having far fewer resources to perform that care. After 25 years of nursing, mostly in critical care areas but with extensive floor nursing, I have left the hospital. I now work for in a state institution caring for the developmentally disabled. I have 40 patients every night to adminster medications to, but most of them are not sick. Most of them. I have 4 patients with metastatic cancer who will die from the disease. I have patients with heart disease, diabetes, and of course, many many patients with psychiatric problems. But even so, this is a venue where I can give the kind of care I was trained to give - care that is compasionate, high quality, and effective.

Two more things I think are really important to mention here. First, people always say the respect nurses. That respect was shown by families in your report. Unfortunately, this is seldom seen for the floor duty nurses. People tend to treat them as if they are waitresses and think their most important duties are to get coffee or snacks. I have had horrible things said to me about how long it took me to get someone water when I was in fact trying to do a complex sterile dressing change on a surgical site. I just went to the break room and cried. Second, it may be that support systems and training will encourage nurses to stay in the hospitals. Certainly a lower patient load would help. But that is unlikely to happen at any but the best and most successful hospitals. Only a nursing administrator can make the statement that money will not keep nurses on the job. In a country that practices medicine for profit, nursing salaries are not going to be attractive in many places. My state, Florida, is one in which nurses are paid quite poorly given the responsibility we are expected to accept. Most nurses I know could certainly be enticed to stay in the profession if the pay were better. Finally, we need to stop looking at nursing as a pedistal profession. Nurses are human. They work under very difficult circumstances. They make mistakes. We try to be very careful, with multiple checks on everything we do. But mistakes do happen because perfection in any human activity is not possible. And hospitals have been told over and over again what is needed to reduce the kinds of errors that are most common, but they refuse to spend the money necessary to change the outdated systems that lend themselves to the confusion and chaos that lead to errors.

Thank you for taking the time to listen to these problems. I love being a nurse. I am proud of my profession. I want future nurses to feel the same way I do. Whatever you can do to educate the public to the problems in nursing and how those problems adversly affect patients is greatly appreciated by all of us.

Commenter:Melanie TylerLove your program consistently....and I have to tell you that your piece on Nurses really hit home for me. I am the mother of three grown children and two of those children for the past two years have been battling Cancer. My son, DX'd w/ Leukemia and the n6 months later my oldest daughter was DX'd w/ Breast Cancer. For the past two years I have done nothing but LIVE in two different hospitals. My son was in two different hospitals, Columbia University Medical Center, in Comumbia, MO and Barnes-Jewish in St. Louis, MO. My daughter was in St. John's back at home in Joplin, MO. My son and daughter were 5 driving hours (one way ) from each other. It was the nurses who kept me sane, watched over me when I assured them they shouldn't , and in addition did everything including moving mountains and staying after their shifts of 12 hours to help take care of my son when he was a breath away from dying. In, the other circumstance, I had to worry about my daughter because St. John's is a small hospital and does not have the resources to get or keep good nurses and many, many times I had to really battle w/ below par nurses there for the safety of my daughter. So, when I was in Columbia or St. Louis, my son was getting the very BEST of care, and then going to the other extreme where we couldn't find a single nurse capable of putting in an IV into someone whose veins have shriveled due to all the Chemo treatments, and put her through incredible amounts of pain. So, I have had true experience that the interships and nursing programs that the larger hospitals have truly make a profound difference . I've seen that first hand. It is an incredibly important problem. We NEED nurses who are indeed capable and intelligent and knowledgeable. Boy , in a community like Joplin who has TWO hospitals, but neither hospital has but a handful of nurses really worthy of their title, and the rest are at even times dangerous, I can tell you it is just down-right scary. Thank you for bringing this to public knowledge and hopefully there will be more done to help out the Nursing problem. God, knows , in the small cities, for sure, they need it!

Commenter:Jenna ChildressThank you for recognizing the value of nurses and the nursing shortage. I have been an RN for 37 years with the majority of these in critical care. I think that salary is overlooked by most as a reason why more people don't select nursing as a career. Administrators are usually the only nurses that are asked about this being a factor and they always talk about how satisfying the profession is and that nurses aren't nurses for the money. I think they need to wake up and realize that smart young people are looking at how they are going to survive in this economy as well. Nurses don't usually have pensions. We work nights, holidays, and weekends with little compensation and mandatory overtime is the norm. Show these bright young people how important they are by paying them at least the same as you would a mechanic or plumber. Put health care dollars in the hands of those who will probably be feeding you someday. Thank you! Jenna Childress RN, BSN, CCRN

Commenter:Kris RNI enjoyed your program on the Nursing shortage. I have been a nurse for 26 years and will be part of the ones that will retire over the next 10-15 years. Some additional reasons for the shortage are as I see it:
1. Shift work in hospitals not having much control over when you work. Some hospitals still requiring that a nurse rotate all three shifts- which means you don't have much of a personal life.
2. Too many patients that are very ill to care for safely.
3. Bad treatment by physicians although this is changing it still exists far too often.
4. Increased litigation by patients- sometimes seen as jackpot juries in states that do not cap malpractice litigation.
5. Not enough money to live well on. Most make around 60K a year- too little for the life and death decisions that you have to make.
6. More choices for women today to go into other professions that pay more and have less risk to the job.
7. The profession is so difficult that I strongly urged my own children and young people that I know not to go into it unless they really felt that it was their calling. Therefore, my children have pursued safer more lucrative professions.
8. Dealing with the public can be very difficult.
9. Risk of infectious disease such as HIV or more easily transmitted multi-drug resistant TB. In otherwords you cough and I get it.
10. Lack of support by the hospital administration.
11. Forced overtime in hospitals.
12. Available work such as what I have pursued working for an insurance company for the last 13 years. Monday- Friday business hours with few holidays and weekends.
Means no one throws up on you!!
13. Many nurses approximately 75% are married and have spouses that have jobs. Less need to work outside of the home or less need to work full time when your spouse works also. The percentage of married nurses is much higher than the percentage of married women in the general population of the US.
In spite of all of this it's still a serious problem. Your program did a good job of covering some of the issues.
The faculty shortage of nursing instructors is a serious problem that you highlighted well. Yes the lack of pay is a large issue. However, in Associate Degree programs and RN diploma schools the criteria for a nursing instructor is a Bachelor of Science in Nursing. They could consider someone that is a Registered Nurse and has a Bachelor's degree in another field. They insist on the BSN. But the real issue is the low pay. A full time nursing instructor makes 10K less than the average nurse in the hospital.
Few nurses are under the age of 30- wow that's scarey. Who will care for us when we get old? It's just not seen as an attractive profession by Gen X and Y.
Not sure what the solutions are other than better salaries, lower patient to nurse ratios, better treatment by physicians, and more control over scheduling in the hospital. These things are better now than years ago, but there is still a long way to go.
I left hospital nursing long ago and never looked back-
I'm too old to run around the hospital like I saw those great young graduate nurses that your program profiled!
Clearly something needs to be done but what? At least we are starting to ask the right questions- now we need to decide what the solutions are going to be.
Maybe statutory liitations on nurse to patient ratio such as California has. Maybe caps on malpractice awards by juries. Maybe better salaries and more self scheduling for nurses by hospitals. Maybe a zero tolerance policy for physician mistreatment of nursing staff. Maybe making a basic health insurance policy for every American a right instead of a commodity.
In spite of all of this, I am thankful that I am a nurse. It pays my bills and I have a choice of many jobs even in a tight economy.

Commenter:D ThompsonI was watching your program the evening of October 24th. I was more than a bit interested in that I am a nurse, and have been a nurse for some time.
I had worked as a nurse for many years, and decided that I needed to go back to school. I chose something totally unrelated to nursing to study. I was very tired of nursing, and truly needed a change. You need to understand that if I had put the effort I put into going back to school into studying nursing, I would have an advanced nursing degree, and would have been financially much more comfortable than I am now. I just could not bring myself to study nursing. There were, as still are, many reasons for this.
It is my opinion that nurses view other nurses that work at the bedside as losers. It is my opinion that nursing schools teach the new nurses that they are to manage the care, not to deliver the care. It is my opinion that the longer you are a nurse, the less respect you receive from your employer, new grads, and nurses that are no longer at the bedside. There seems to be a sense carried by new grads that as they are new grads, they have all the up to date information, all the insight, and understanding. This is reflected by administration and nurse managers. The administration and nurse managers seem to be of the opinion that if you have not moved away from the bedside, you are as I have already stated, a loser.
Various examples of this would be:
In a conversation with another nurse she informed me that she quote, had the perfect nursing job. No nights, no weekends, no patient contact. unquote This is a comment I heard more than a few years ago, though this thought still persists.
I have recently been in a staff meeting where my boss and her boss were both in attendance. I happened to mention that, quote I have been to hundreds of these meetings over the years. unquote The response of the person who I am calling my bosses boss was to roll her eyes and clearly state for all to hear, quote I bet you have. unquote
There is something called the Nightingale Awards, given to experienced nurses. This is given to nurses that are recognized by other health care professionals as being exceptional. One of our local TV stations ran a piece on this award. There was a very short mention of the actual award, and then the head of the local nursing school came on. The conversation was no longer about experienced nurses being recognized, but about how many and how great the next batch of new grads was going to be. I sent a letter to both the TV station, and to the school of nursing. The TV station actually redid their piece, and actually acknowledged that nurses with experience were of value and to be given credit for their efforts. The nursing school assigned one of their instructors to reply to my note. What I got from them was a quite lengthy, rambling note that did not address my point.
These are just some very small glimpses of the things that I experience, and have experienced, for a large portion of my adult life. I noted that you mentioned that one of the new nurses you are following has been keeping a log. I also have kept a long, off and on, for a long time. Perhaps you would care to view my log, and compare my experiences to what your new grad is experiencing. It could be an interesting comparison.

Commenter:Judy McKenna

Awareness of the nursing shortage facing our nation is crucial to the future of nurses everywhere. We are an ever present, hard working and dedicated team of professionals that can use all the support the American public can give. Perhaps more nursing scholarships will be funded because of your timely and thoughtful journalism.
Thank you,
Judy McKenna R.N.

Commenter:L isa C. Mann, BA, AS, RN, CCRNI'm a nurse now for 14 years. I'm CCRN certified. I've worked telemetry, ICU and now PACU. 'Nurses Needed' seemed more of a glossy recruitment tool than a hard look at why nurses don't stay in the profession they love.
If you check back with your two new grads in 10 years you will hear the real reasons nurses leave the job they love. Little or no ancillary support(nursing assistants), poor sometimes dangerous nurse to patient ratios, the heavy physical as well as emotional toll, no cost of living increase in salary for years at a time and a pay scale that doesn't offer the salary growth of other professions. Don't forget voluntary overtime that is used as a staffing tool to avoid hiring and importing of foreign nurses to undercut our payscale. Medicare cutbacks do not help either. Finally, my personal favorite, there are the pens and mugs or little flower pots or pins offered as gratitude by hospitals to nurses during nurses week. It's humiliating! I can only imagine the reaction of an attorney if his/her boss presented him/her with such a thank you! But then we are women and we like cute useful things, right? Wrong! Give me respect and show me the money for a damn hard job well done!

Commenter:T Sunog, RNIt always surprises me when the subject of the nursing
shortage is discussed. It's not the lack of nurses that is surprising. Rather, it is the fact that the issue of supply and demand is rarely brought up. In almost every industry when there is increased demand and lack of supply you can bet on one thing,the cost or price of that item that is in demand goes up. The cost of gasoline is one we can all relate to. More demand and less supply translates to increased cost.

You would think with the lack of supply of nurses this would also hold true. It does not and it should! I guarantee that when the price is right there will be no lack of nurses. Raise salaries-increase supply! The rest is all nonsense.

In NYC when the salary of rookie policemen was somewhere around $25,000 applications fell below the radar. Now with starting salaries up to over $40,000 applications are rolling in. Do the math!

Commenter:Anonymous for Now I do not think we would have a nursing shortage if hospitals were run well. The exceptions to the wage and hour laws that are made for hospitals and the COMPLETE failure of oversight OF ANY KIND make working in them a hell the likes of which you cannot fathom if you have not lived it. An unnecessary hell. Doctors like all others need to comply with the LAW. Inspections need to happen and they should not be forewarned about when.